文献抄读精美PPT模板1

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1、TrendsinMortalityFromAllCausesAmongHypertensiveAdultsintheUnitedStates2012-05-16目录Background1Methods2Results3Disscussion4BackgroundThisarticlereviewstheepidemiologyofADHFandtheprofileofpatientssufferingfromthiscondition.Itdescribesfactorsusedinassessingprognosisandpresentstreatmentoptio

2、ns.Althoughnocurrentlyavailabletreatmentshavebeenshowntofavorablyaffectlong-termoutcomes,thereareavarietyofstrategiesandapproachestomanagementthatareexpectedtoreducemorbidityandmortalityfollowingdischargeafterADHFhospitalization.MethodsTheimportanceofthetransitionfromhospitaltotheoutpat

3、ientsettingisdescribed.Particularattentionshouldbefocusedonprovidinghealtheducationtothepatientandtheirfamilyatanappropriatelevelofmedicalliteracyaswellasensuringearlyfollow-upevaluationafterhospitaldischarge.ResultsReleaseofaldosteroneisstimulatedbydecreasedrenalperfusionviaangiotensin

4、II,hyperkalemia,andpossiblyadrenocorticotropichormone.2Aldosteroneexertsitseffectsbybindingtomineralocorticoidreceptorsinrenalepithelialcells.Aldosteronehasseveraldeleteriouseffectsonthefailingheart,primarilysodiumandfluidretention,butalsoendothelialdysfunction,leftventricularhypertroph

5、y,andmyocardialfibrosis.2,3Plasmaaldosteronelevelscanbemarkedlyelevatedinpatientswithheartfailure,likelyduetoactivationofthereninangiotensin-aldosteronesystem.ElevatedaldosteroneandangiotensinIIlevelshavebeenassociatedwithhighermortalityratesDisscussionWhilethedifferencesbetweenthetwodr

6、ugsremaintobedetermined,themostimportantdifferencesinclinicalpracticeareselectivityforreceptors(andhencetheirantiandrogenicsideeffects)andprice.Eventhoughitisavailableasagenericdrug,eplerenonestillcostsatleastthreetimesmorethanspironolactoneforthesamedosageandindication.DisscussionTheph

7、armacologicdifferencesbetweenthetwoARAshavebeendescribedearlier,andguidelineshaveadvocatedevidence-baseduseofARAsfortheirrespectiveindications.Therehavebeennolarge-scale,head-to-headcomparisonsofspironolactoneandeplerenoneintheheartfailurepopulation,andinclinicalpracticethedrug